Pharmacology (HSC 343) Final Exam Questions with Correct Answers

regular insulin - ANSWERS- short-duration, slow acting - onset: 30 min-1 hr - duration: 6-10 hours NPH insulin - ANSWERS- intermediate acting - onset: 1-2 hrs - duration: 16-24 hours insulin glargine - ANSWERS- long-acting - onset: 1 hour - duration 24 hours insulin lispro - ANSWERS- rapid-acting - onset: 15 min-30 min - duration: 3-5 hours insulin aspart - ANSWERS- rapid acting - onset: 12-18 min - duration: 3-5 hours anatomical absorbance (greatest to latest) - ANSWERS- abdomen - arm - thigh - hip all insulins are CLEAR--- except for what insulin? - ANSWERSNPH insulin (it is cloudy) what insulins may be given IV? - ANSWERS- regular - aspart - lispro - glulisine when mixing insulin, which insulin would you draw up first? what are the steps after that? - ANSWERS- when mixing insulins, draw up the SHORT-ACTING insulin into the syringe first, then NPH why would you draw up the short-acting insulin first when mixing insulins? - ANSWERSthis stops contamination of the short-acting insulin w/ NPH S/S of insulin OD - ANSWERS- hypoglycemia (dizziness) - weakness - sweating - HA - increased HR - anxiety - tremor - mental and visual disturbances how would you treat insulin OD? - ANSWERS- eat something sweet or out the pt on a sugar drip (if in the hospital) Metformin - ANSWERS- widely used - oral drug Type II DM - may be used w/ other drugs for diabetes - increases HDL, decreases BP, weight loss - SE: GI upset, acidosis - DO NOT use in pts w/ renal diseases or liver disease - d/c before using iodinated radiocontrast media, wait acarbose - ANSWERS- oral drug for Type II DM (glucosidase inhibitor) - inhibits the enzymes that break down oligosaccharides into monosaccharides - delays digestion and prolongs absorption of CHO, decreasing PPH - do not cause postprandial hypoglycemia - ADRs: GI upset and flatulence - pts take these drugs w/ first bite of each meal tolbutamide - ANSWERS- older drugs that stimulates insulin release from the pancreas - onset: 30 in-1hr - duration: 6-12 hrs Sitagliptin - ANSWERS- PO used to stimulate insulin release Canagliflozin - ANSWERS- excretes glucose through the kidneys -- increases urine excretion of kidneys SE: yeast infections and genital gangrene Exanatide - ANSWERS- injectable, that slows gastric emptying what is PPH? - ANSWERSpostprandial hyperglycemia - it is correlated w/ increased risk of cardiovascular disease signs of hypoglycemia - ANSWERSearly signs - fatigue, HA, drowsiness, lassitude, tremulousness, nausea late signs - weakness, sweating, tremors, nervousness, LOC/convulsion (use Glucagon for this) signs of hyperglycemia - ANSWERS- thirst. polyuria, drowsiness, flushed skin, fruity odor to breath, LOC - instruct family to call physician, EMT - have insulin ready - observe pt closely after insulin is administered what is ketoacidosis? - ANSWERShigh blood glucose -- above 300, high ketones in blood and urine how is ketoacidosis treated? - ANSWERS- IV fluids and electrolytes - IV insulin- but given slowly to reduce blood glucose levels slowly (initial bolus, then continuous infusion to maintain BG levels) - Bicarb for acidosis, K+ for hypokalemia what is HHNKS? - ANSWERShyperglycemic hyperosmolar nonketonic syndrome what does thyroid do? - ANSWERS- it synthesizes and releases 2 hormones (T3 and T4) what do T3 and T4 do? - ANSWERSregulate many facets of cellular metabolism why is thyroid hormone (TH) important? - ANSWERS- they are the main controller of how we burn calories and are also permissive w/ respect to catecholamines S/S of hypothyroidism - ANSWERS- fatigue, weakness, cold-intolerance, weight gain, anemia, cretinism S/S of hyperthyroidism - ANSWERS- nervousness, weakness, heat-intolerance, sweating, weight loss, exophthalmos (Graves disease) synthroid - ANSWERS- PO or IV - mimics TH - most commonly prescribed drug in the US - DOC for HYPOthyroidism -- life long therapy PTU (propylthiouracil) - ANSWERS- antithyroid - blocks iodine incorporated into THs and also blocks conversion of T3/4 in periphery - long term use in absence or surgery of l131 - safe in first trimester of pregnancy -- the switch to methimazole methimazole - ANSWERS- antithyroid l131 - ANSWERS- destroys thyroid w/ a single (or double) dose - can NOT be used in pts who are pregnant - fast and cheap but produces hypothyroidism propranolol - ANSWERS- blocks the CV effects of TH -- decreases the sympathetic activation caused by TH - good during a thyroid storm and pregnancy use of glucosteroids - ANSWERSanti-inflammatory, immunosuppression, and replacement therapy in adrenal insufficiency how to dose steroid drugs - ANSWERS- PO steroids given in the AM to mimic body's normal release or by taper pack hydrocortisone - ANSWERS- - used for status asthmaticus, anaphylactic shock (IV); - PO for Addison's disease - Topical form for itching/inflammation Solu-medrol - ANSWERS- DOC (IV) for acute asthma - allergy inflammation prednisone - ANSWERS- given PO - DOC for maintenance therapy in asthma, and other autoimmune disorders SEs of glucosteroids - ANSWERS- osteoporosis - ulcers - metabolic fat (hyperglycemia, hyperlipidemia, fat redistribution) - growth retardation -- children - adrenal suppression - decreased wound healing - immunosuppression (do not give immunizations) - HTN, glaucoma, increased CNS excitability, menstrual irregularities COX-1 inhibitors - ANSWERSmediate pain, inflammation, clot formation, vasoconstriction/dilation, platelet aggregation, fever, integrity of gastric mucosal barrier, renal homeostasis, labor and patency of the ductus arteriosus COX-2 Inhibitors - ANSWERS- more selective for inflammation - ex.: Celecoxib - main use is arthritis, bu it may affect renal function and has a greater risk of MI and stroke - fewer GI bleeds and no effect on clotting time which antacids cause constipation? - ANSWERSaluminum salts and Ca carbonate which antacids cause diarrhea? - ANSWERSMg salts opiate - ANSWERS- drug for diarrhea - DO NOT USE W/ MAOIs - i.e. Imodium